1. e-Health – Pan UK ? HL7 UK 2006 Dr. Paul Woolman Clinical Information Standards Manager NHS Scotland

2. UK – Four Home countries Are we different?

3. NHS Scotland Health Strategy “Delivering for Health” –Local Community Care –Chronic long term conditions –“The only game in town for the next ten years”-CMO Key focus on –People –Information –Governance ‘Progressive harmonisation and standardisation of ICT’ Clinically led Gradual, Ongoing Change

4. Exploiting what exists Filling the Gaps EHR Project / Future e-Health Programme Clinically led Organisational Change Implementation & Training Standards E-Referrals – SCI Gateway Community Health Index Number Emergency Care Summary (ECS) SCI Diabetes PACS Staff ID and Authentication Clinical Data Standards Development E Pharmacy Generic Clinical Systems Common Drug record & Ward Prescribing Managed Technical Hosting Service * Telecommunications * ‘New Ways’ waiting times definitions * Standards * EHR - SCI Store Terminology Services

5. Why different from England? Different people Different context Different needs Different resource priorities Different timing

6. An illustration: ePharmacy Four core elements, three with IT support: Minor Ailment Service (eMAS) Chronic Medication Service (eCMS) Acute Medication Service (eAMS)

7. Minor Ailment Service Individual registers with a pharmacy Individual presents with symptoms Pharmacist offers –Treatment & advice – prescriptions –Lab tests and advice only –Referral –Associated healthy lifestyle advice –Gets paid capitation fee for services This service went live 1 st July in every pharmacy in Scotland

8. Core Components ~ system N3 network connection Central ePharmacy message store (ePMS) Central Patient Registration System (PRS) System applications for the new contract (GP and Pharmacy) Uses DM+D

9. Electronic Messages via N3 network Core infrastructure components eMAS Practitioner Services Patient Registration System CHI Pharmacy ePharmacy Message Store Payment processing systems MAS eMAS registration and claim forms sent to PSD For those who like boxes and wires.

10. Technologies/Standards in Common N3 network – NHS Net NHS number/CHI XML E-Gif pan-government standards Drug Dictionary DM+D SNOMED-CT (+ICD/OPCS/READ)

11. Why different messages? Timing – started in 2000 Pragmatism Philosophy –Small incremental steps based on what works

12. Does it matter to the user? Spot the difference The difficult thing is learning to drive Changing cars is easy

13. Existing developments in common ENV 13606 – used in GP record exchange – GPEX in 80% GP’s –Moving to GP2GP Archetypes & Templates– ideas used in –clinical data standards –Generic Clinical system developments Document metadata index standards –Now on version 5 Home countries Hub for data exchange

14. Possible future standards in common CDA – first recommended in Scotland three years ago ! RIS-PACS v3 standards – needed now! Logical Record model GP2GP – full HL7 standard? Emergency Care Summary

15. More Info: Paul.Woolman@NHS.Net www.show.scot.nhs.uk www.isdscotland.org